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level: Anticoagulants and haemostasis

Questions and Answers List

level questions: Anticoagulants and haemostasis

QuestionAnswer
Thrombosisformation of a blood clot
Embolusa detached blood clot
Coagulationblood turning into a solid
Collagen plus platelet activation causes a platelet plus via what compoundsvWF and fibrinogen
To form a blood clot what does factors converts fibrinogenThrombin converts fibrinogen to fibrin
What does plasmin docarry out fibrinolysis and clot degradation
Platelets carry out whatA haemostatic plus known as primary haemostasis
Coagulation isthe formation of a fibrin clot or secondary haemostasis
What are some thrombosis activatorsvWF, fibrinogen, thrombin, collagen, ADP
List some inhibitors of thrombosisPGI2, NO2,
TxA2 is aprothrombotic eicosanoid
What four key fucntions does thrombin carry outvasoconstriction, fibrin clot formation, coagulation amplification and platelet activation
Anti-coagulantA drug that prevents blood from clotting
Anti-thromboticA drug that prevents thrombus formation
ThrombolyticA drug that dissolves blood clots
In arterial clots what is more critical platelets or coagulationarterial platelets critical so clot is white
Anti-platelet drugs includeaspirin and clopidogrel
Venous thrombosis relies onCougulation therefore is red
Coagulants includeWarfarin and heparin
Virshows triadBlood flow- immobile i.e. atrial fib., endothelial injury- trauma e.g. atherosclerosis and hypercoagulation- inherited, pregnancy or medication
aIIbb3 antagonists work viamonoclonal antibody, restricted acute care as risk bleeding low efficacy and higher mortality
Aspirin affectsCOX which produces TxA2 inhibiting platelet aggregation
ClopidogrelInhibits platelet adhesion
aIIbb3 antagonistsAbciximab- monoclonal antibody
P2Y12 inhibitor- very goodClopidogrel
What is warfarin and how does it workAnti-thrombotic i.e. a blood thinner, works by inhibiting oxy carbolation of coagulation factors in the liver
Common anticoagulatnsHeparin- 2 forms, warfarin, Xa and thrombin inhibitors
Common clot busters- activate plasminRecombinant tPA, e.g. alteplase, reteplase and tenecteplase, urokinases- abbokiase, kinlytic and streoptokinase
Primary haemorrhage in dentistry isBleeding which occurs during surgery
Reactionary haemorrhage2-3 hours after surgery
Haemostatic agents in dental surgerypassive- Gelatins, collagen etc..
Minor bleeding procedure with anti-coagulant patientsGelatin sponge, fibrin glue and suture
Severe haemorrhage in anti-coagulant patientCauterization of soft tissue bleeding
HemCon dental dressingAchieves haemostasis, fastens the wound for healing as +ve atracts -ve RBCs
If carry out curretage haemostasis is achieved bytransexamic acid, suture or gelatine sponge and local hemostatic agents
Local non surgical interventionsSealants, adhesives, absorbable agents, biologics and combination products aswell as local anti fibrinolytic agents such as transexamic mouthwash, fibrin glue or adhesive, resorbablel collagen or gelatin sponge
Should you ask a patient to stop their anticoagulantNo they could die
Systemic interventions for patients with associated cause for bleeding§ administration of fresh frozen plasma (FFP), platelets or both § factor replacement therapy, using recombinant or plasma‐derived anti‐haemophilic factor A (FVIII) or anti‐haemophilic factor B or VWF § intranasal desmopressin § oral or intravenous tranexamic acid intravenous epsilon amino‐d‐caproic acid